1.
Image credits included in presentation
THE MANY FACES
OF
IoT
IN HEALTHCARE
INTERNET
OF
THINGS

2.
Machine to Machine
(M2M)
Hi, I’m...
IoT
Embedded
Internet
Web of
Things
A subset of IoT
IPv6 may be adopted
Machine-Type Communication
(MTC)
Internet of
Things
but my friends call me...
but non-IP
protocols
are also
used
Intranet of
Things
Claro Partners
Smart...
SmartEnergy, SmartCity,
SmartGrid, etc.
Internet of
Everything
Cisco
IoT evolving into WoT
with integration
into the
Web
Application layer
using standard web
protocols
Industrial
Internet
GE...
Replacement for
SCADA &
Telemetry
...also Industrial
Internet Consortium
and others
Industrial
Internet of Things
(IIoT)
Includes people, computers
and data
Connected devices but
within proprietary platforms
Vehicle to...
...Vehicle (V2V), ...Infrastructure (V2I),
...Anything (V2x)
Ubiquitous
Things that think computing

3.
Almost ‘anything’
—including ‘living things’—
connected to the internet
regardless of location or other
physical restrictions.
Source: Gareth Baxendale, Head of Technology Services at the NIHR Clinical Research Network, WiFi enabled cows and the Internet of Things

4.
Monitor
Analyse
Process, analyse and
communicate data
Trigger Alert
Action
Collect and
record data
Required action taken
by device or human
The Internet of Things is
process driven

5.
Today, there are already more things
connected to the internet than people
26 billion
50 billion
75 billion
200 billion
Number of devices predicted to be connected to the internet by 2020
The human brain has 86 billion neurons
Flaming Lotus Girls Neuron by Ann Larie Valentine on Flickr https://flic.kr/p/75SmyS
Cisco
Morgan Stanley
Intel
Gartner

6.
What does this
look like in
healthcare
?

7.
Source: The Internet of Things Architecture, IoT-A

8.
Higher quality delivery
Both little data...
What can IoT do for healthcare?
Ability to react with speed
...and big data
Ability to act at scale
Can affect whole communities and cities

9.
Broader
model of
healthcare
Prevention & Wellness
IoT has a far reaching
impact across all
determinants
of health
Figure Source: Dahlgren, G. & Whitehead, M. (1991) The main determinants of health in Policies and strategies to promote social equity in health: Background document to WHO—Strategy paper for Europe

10.
Being able to monitor and support a person
free from ‘physical constraints’
will change the way doctors deal with patients.
Source: Gareth Baxendale, Head of Technology Services at the NIHR Clinical Research Network, WiFi enabled cows and the Internet of Things

11.
30.3% 69.7%
Percentage of IoT devices
found in healthcare
Percentage of IoT devices
found elsewhere*
* Business/Manufacturing, Retail, Security, Transportation
The predicted global
worth of IoT in healthcare
in 2025
$2.5
trillion
Deployment of the Industrial Internet can help to drive
down costs from clinical and operations inefficiencies by
roughly 25% or about $100 billion per year
Sources: Intel, A guide to the Internet of Things & General Electric Company (2012) Industrial Internet: Pushing the boundaries of minds and machines

12.
But is this just a
utopian vision?
Image: © 2014 Debbie Stocker

13.
“Have I taken my medication?”
Day 304: New Meds by kizzzbeth on Flickr https://flic.kr/p/bCBGFk Inyección de insulina by Sari Dennise on Flick https://flic.kr/p/7LNKnN; Lifeblood by Andrew Butitta on Flickr https://flic.kr/p/6g5zCD; Pills by David K on
Flickr https://flic.kr/p/5Ya3x; By Alex on Flickr https://flic.kr/p/84G5UR; Pudge with his inhaler by Thomas Widmann on Flickr https://flic.kr/p/NiwcR

14.
Available to buy or in development today...
ELECTRONIC
PILL DISPENSERS
Designed to remind
individuals to take
their medication at the
right time and to ease
the burden of
complex medication
regimens, electronic
pill dispensers such as
my uBox and
MedMinder alert both
the patient and their
caregivers.
SMART
WATCHES
Already designed to
act as a health and
fitness companion
with all the
capabilities of a
fitness tracker, smart
watches (such as
Apple Watch) have
the potential to
integrate with
multiple
technologies,
including those
described here.
ELECTRONIC
BOTTLES, CAPS
AND POUCHES
Wireless smart pill
bottles, such as
Adheretech, measure the
volume of tablets or
liquid left in a bottle,
while GlowCaps use light
and sound to signal
when it’s time to take
your medication. Inhaler
attachments, such as
GeckoCap and
Asthmapolis, monitor
where and when an
inhaler is used.
‘PHARMACY ON A
CHIP’
Currently undergoing
clinical trials, microchips
drug delivery
technologies administer
controlled doses of a
drug at precisely the
right time via a microchip
inserted on the waist.
Still in its infancy, the
technology holds
promise for improved
patient adherence
managed remotely.
BIOMONITORING
DRUGS
Ingestible sensors as
small as a grain of sand
exist today. Helius by
Proteus Digital Health is
a digital health feedback
system. Embedded in a
tablet, sensors
communicate with a
patch worn on the
stomach. This then relays
information to your
phone, and further to
your support network
and care providers.

15.
“I want to track my own health and that of loved ones.”
Pregnancy by Titiana Vdb on Flickr: https://flic.kr/p/e4nLge Image by Darran Baldwin: https://flic.kr/p/fff9ut
Runner by Stuart Grout on Flickr: https://flic.kr/p/9HXRiX Bathroom scale by Magnus D on Flickr: https://flic.kr/p/8oDVuo

16.
Available to buy or in development today...
FITNESS
Designed to provide
insights into our own
health and motivate us
to increasing levels of
fitness, many of us are
no doubt familiar with
wearables that track
our activity, such as
the Jawbone UP, Fitbit,
or more recently,
Misfit Wearables’
Shine. LG and Intel
also both produce
smart ear buds that
monitor your pulse.
HOME
MONITORING
Home monitoring
matters to both
families and care
providers alike as it
enables
independence.
Systems such as
Sensormind,
Sonamba, Numera
Libris and Libris+
use sensors to
detect activity,
analyse behaviour
and automatically
detect problems.
WELLBEING
Psychological wellbeing is
vitally important and IoT
can help. From wearables
focused on breath
patterns and fitness, such
as Spire and Lumafit, to
stress mapping bicycle
helmets, such as
MindRider. Or what
about Olive, an intelligent
bracelet that monitors
heart rate, skin
conductance, ambient
light, motion and skin
temperature?
FAMILY
IoT knows few bounds
when it comes to
supporting our loved
ones. From the virtually
invisible electronics of
MC10 (above) to Pixie
Briefs smart nappies,
which analyse urine,
check hydration levels
and identify signs of UTIs.
Kolibree is a connected
and gamified electric
toothbrush, while other
wearables help keep
track of your pregnancy.
CLINICAL
SUPPORT
AliveCor is a heart
monitor that attaches to
your smart phone and is
capable of recording
ECGs. Physicians can use
the technology to detect
arrhythmic cardiac
disease, irregular
heartbeat or abnormal
heart rhythm. AliveCor
ECGs can also be
automaticallly uploaded
into select Electronic
Health Records (EHR).

17.
“Can we get to the scene of an emergency faster?”
DSC08469 by perthhdproductions on Flickr https://flic.kr/p/daiBwA; Ambulance in Motion by Benjamin Ellis on Flickr https://flic.kr/p/6qa5ym;
Paramedic at Vauxhall Helicopter Crash by R4vi on Flickr https://flic.kr/p/dM8x4M; London Air Ambulance by Smudge 9000 on Flickr https://flic.kr/p/4UQzUK

18.
eCall (an interoperable, harmonised in-vehicle emergency call system)
will be mandatory in all new car and van models produced within
the European Union by October 2015
Sources: HeERO Harmonised eCall European Pilot & Daily Mail (2014) EU to bug every car in UK with tracker chips

19.
“We want to prevent and control infections.”
MCs Visit to the Hospital by kris krüg on Flickr https://flic.kr/p/cyVcQ; Washing hands (before shot)_0033 by James Emery on Flickr https://flic.kr/p/4xFfxG;
Clean Hands by Arlington County on Flickr https://flic.kr/p/7zg6GJ; Poke by Thirteen of Clubs on Flickr https://flic.kr/p/9jfqsg

20.
To reduce healthcare associated infections (HAIs), companies such as
Intelligent M, HyGreen, IBM in collaboration with OhioHealth, and
BIOVIGIL are creating sensor technologies and networks to monitor
hand washing practices in real-time.
Sources: Postscapes, Intelligent M: Reducing infection through RFID; Postscapes, Hand hygiene monitoring system: HyGreen; BIOVIGIL;
eWeek (2014) IBM, OhioHealth use big data to prevent infections in hospitals

21.
“Is it possible to develop a predictive lifesaving approach?”
Inside the air ambulance on 17th from Rourkela to Bhubaneswar by Sadasiv Swain on Flickr: https://flic.kr/p/ovrc7s; EEG with sleeping boy by Jemaleddin Cole on Flickr https://flic.kr/p/d8szf;
A mother’s hands by Cheryl on Flickr https://flic.kr/p/5QRFfo; Canberra Hospital Walk-in centre staff at work by DIBP images on Flickr https://flic.kr/p/9tTxUR

22.
The LIFEPAK 15 portable heart
monitor and defibrillator allows
medics in the field to capture patient
data and send this information directly
to the hospital. Such M2M technology
enables faster response times. It also
ensures that patients are routed to
the correct hospital for treatment,
appropriate caregivers are notified
and swift diagnosistic decisions are
made.
IBM are working on a host of
predictive solutions designed to
improve healthcare in real-time,
enable faster interventions and save
lives.
Project Artemis, developed in
collaboration with the University of
Ontario Institute of Technology and
the Toronto Sick Kids Hospital, allows
subtle changes to be detected in
nosocomial infected infants 12 to 24
hours before any outward signs
appear.
Other projects aim to detect
complications in brain injured
patients, stroke victims and critical
patients in ICU before they occur.
Sources: PTC (2014) Saving lives: ambulances get connected to the IoT; M2MNow (2011) Multi-tech cellular development platform and Physio-Control combine to save lives; IBM Big data in healthcare: real-time
health monitoring and intervention; IBM (2013) UCLA relies on breakthrough ‘big data’ technology from IBM to help patients with traumatic brain injuries; IBM (2010) IBM Analytics helps medical
researchers detect complication in stroke patients; IBM (2013) Emory University Hospital explores ‘Intensive Care Unit of the Future’

23.
“We want to increase medical device utilisation.”
CT Scanner, Crash Cart by Civilian Scrabble on Flickr https://flic.kr/p/vUki6;
treat2 by MilitaryHealth on Flickr https://flic.kr/p/cRK86s; Big MRI by liz west on Flickr https://flic.kr/p/kJ4Pa

24.
There are
105,000 CT scanners and MRI machines
globally
By connecting medical devices and machines to
the internet it becomes possible to monitor in
real-time, run remote diagnostics, provide virtual
hands-on support, automate replenishment and
analyse utilisation.
Using IoT, Varian Medical Systems have seen a:
50% reduction in mean time required to repair
connected devices
$2,000 reduction in service costs for each
problem resolved remotely
20% fewer technician dispatches worldwide
Sources: Forbes (2014) 3 ways the Internet of Things is revolutionizing health care & General Electric Company (2013) The Industrial Internet @ Work

25.
“As a nation, effective public health policy is important.”
Crowds by H. Michael Miley on Flickr https://flic.kr/p/f9Jjxv; Driving Cars in a Traffic Jam by epSos.de on Flickr https://flic.kr/p/9w8eWL;
Map of London sewers Westminster by Matt Brown on Flickr https://flic.kr/p/83ZKDt; GWU School of Public Health Building 42840 by Ted Eytan on Flickr https://flic.kr/p/nUc1et

26.
Underworlds: smart sewage system
Examining aggregated wastewater
across several cities, the Underworlds
project is designed to establish the
techniques and technologies required
to deploy a near-real-time network
of biosensors, automata and
purpose-built labs.
Once realised, this will enable real-time public health
strategies, inform policy, and provide greater insight into
urban health.
Source: Wired UK (2014) ‘Smart toilets and sewer sensors are coming’
Decorated sewer cover by Chris Schrier on Flickr https://flic.kr/p/9jVFCd

27.
Sparks to ignite a flame
Tea candle in the dark by Markus Grossalber on Flickr https://flic.kr/p/du6AgS

28.
Healthcare is a late and slow
adopter of technology
Reputedly one of the
slowest adopters
—second only to shipping
The bow of Majestic Maersk by teralaser on Flickr https://flic.kr/p/gbi4Kg
Sources: The Healthcare Industries Task Force (2004)
& Tim Jones, Board Member West Midlands AHSN (2013)

29.
An unofficial online survey of WiFi availability
for frontline NHS staff found
only 23%
had access to free WiFi
Others were denied access
even where WiFi was available
or had to pay for it
Source: Professor Jonathan Kay, Clinical Informatics Director, NHS England (2013)
Survey run by NHS Hack Day community with support from HANDI Health,
Tactix4 and openGPSoC; 650 respondents Free WiFi by Sébastien Bertrand on Flickr https://flic.kr/p/juq2v

30.
Information governance
challenges are significant
Interoperability | Data integrity
Access control | Data quality | Security
and Compliance
Back to Work by Death to the Stock Photo

31.
Source: Almost Human, ‘Arrhythmia’, Season 1, Episode 6

32.
Source: Wired (2014) It’s insanely easy to hack hospital equipment
2 year study
All medical equipment: radiology, MRI, ultrasound, mammography systems,
cardiology, oncology, lab systems, surgical robots, fetal monitors, ventilators, anesthesia
It was possible to deliver random shocks to a patient’s heart,
remotely manipulate drug dosages, change radiation exposure limits in
CT scanners and alter digital medical records

33.
Reimbursement for digital health
interventions is still a work in progress.
Steve Blank
The stakeholder landscape is challenging—more often than
not, the economic buyers and end users are not the same
but both need to be convinced!
WBS International Healthcare Case Competition 2014
Sources: Rock Health (2014)
Reinventing Life Science Startups Part II:
The rise of digital health & WBS
International Healthcare Case
Competition Participant Briefing: Part 1
Business Model Canvas: Business Model Generation

34.
How will change happen?

35.
Adoption of
industrial
internet by
healthcare
How will change happen?

36.
Adoption of
industrial
internet by
healthcare
How will change happen?
Consumer
adoption and
demand

37.
Adoption of
industrial
internet by
healthcare
Change is inevitable
Consumer
adoption and
demand

38.
Make your own healthcare role
IoT enabled
Lobby for change and access to IoT
in your healthcare environment
Educate yourself on what’s
available. There’s usually a tech
solution out there somewhere!
Recommend IoT solutions to patients
Use IoT for your own benefit
Find an executive sponsor or
innovation champion to support you
Make a note of patient
recommendations and share these
with your colleagues
I’m a healthcare
professional.
What can I do?
1
2
3
4
5
6
7

39.
Use Google to learn about
Healthcare IoT solutions
Lobby for change with your
doctor and consultant
Recommend IoT solutions
I don’t work in to friends
healthcare.
What can I do?
Use IoT for your own benefit
Buy IoT presents for people
Join a patient group
Become politically active
1
2
3
4
5
6
7
8
Start an IoT business

40.
If you would like support to develop your
Internet of Things strategy or would like to
understand the disruptive nature of these new
technologies and business models, contact the
Stocker Partnership and get started today!
+44 (0)24 76 100 193
hello@stockerpartnership.com

41.
STOCKER
PARTNERSHIP
The Stocker Partnership
is a strategic innovation
consultancy
We help organisations to
create and exploit new
opportunities
024 76 100 193
hello@stockerpartnership.com
Matt Stocker
Debbie Stocker
www.stockerpartnership.com
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WE’RE NOT
BIG
BUT WE ARE
CLEVER
@mattstocker
@debbiestocker
Illustrations by Stina Jones (stinajones.co.uk), and Matt Stocker